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Full text of "Rapid Population Growth Consequences And Policy Implications"

costs and dangers of illegal and unskilled abortions outweigh whatever other arguments are advanced in behalf of restrictive abortion laws. Arguments for community health and safety, and for women's personal freedom, are carrying the day in many communities, although the acceptance of legal abortion is far from uniform from one society to another or within societies.
To the health planner this situation presents some very serious questions, whether abortion is a legal or extra-legal means of fertility control. The prevalence of induced abortion beyond the law (particularly if in epidemic proportions) results in serious demands on health services for medical salvage procedures. In some hospitals in developing areas, from one fourth to one third of hospital maternity beds are used for postabortion cases. Yet low-cost legal abortion service cannot be provided unless there is a realistic resource base of facilities and trained personnel. This must be one element in the decision whether to provide legal abortion facilities as a major component of a fertility control program designed to contribute to social and economic development. Insofar as possible, the need for abortion should be minimized by providing women who wish to avoid pregnancy with easy access to contraceptive materials and information.
However, the complete elimination of abortion through the effective use of contraceptives is a distant and probably not attainable goal. In those societies in which the drive to limit family size is strong, the use of abortion tends to rise. It also tends to rise after the inception of effective and extensive contraception programs which help to inculcate a small-family norm. Nonetheless, experience in Japan and the USSR shows that the goal of eventually decreasing the rate of induced abortion by the use of other family planning methods is feasible when accompanied by intensive education and information programs.
Family Planning
The leaders of many developing countries see high natality levels as a handicap to overall development. During the next 20 years the trend toward expanded and intensified family planning programs will undoubtedly increase. In some societies, there are already attempts to achieve specific lower levels of population growth. In others the emphasis is more general—to improve maternal and child health and to alleviate the poverty that is associated with large families.
A national family planning program and government health services can interact in three ways:
(1) Particularly where a variety of fertility-control methods is offered, and especially if these include sterilization or abortion, the family planning program will often be a part of the personal health services provided by the government. The requirements for frontline workers are different for some